A quality improvement provider protocol addressing perinatal depression identification and treatment in a prenatal clinic

Depression during the perinatal year affects one in seven women, making it the most common complication of pregnancy. It has been well-documented that perinatal depression is associated with poor outcomes in both maternal and child health. Universal screening for depression is feasible and screening with follow-up improves perinatal outcomes for mothers and their children. It has been shown in the literature that lack of provider education and confidence is a barrier to identification and treatment of perinatal depression. Therefore, the purpose of this quality improvement project was to improve provider screening and management of perinatal depression at a prenatal clinic in central Texas through provider education and implementation of an evidence-based screening and referral protocol. A pretest/posttest design was used to evaluate provider beliefs, attitudes, and self-efficacy before and after implementation of an evidencebased protocol and an educational webinar covering perinatal depression, screening tools, treatment options, and when to refer. Three of the 13 provider survey items addressing a sense of responsibility and self-efficacy reached our goal of 10% improvement. The other items did not reach this level, but showed a positive shift towards increased provider self-efficacy. One of the important outcomes of this project was to create a network of mental health providers to whom the clinic could refer women with positive perinatal depression scores.